Acne
Also known as: acne vulgaris
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Guidelines of care for the management of acne vulgaris
American Academy of Dermatology (AAD) · 2024 · 2024 guideline
The AAD acne guideline hub, hosting the current guideline published in the Journal of the American Academy of Dermatology. It grades topical and systemic treatment options for acne vulgaris, including retinoids, benzoyl peroxide, antibiotics, hormonal therapies and isotretinoin.
- The AAD page presents this as the current acne guideline, replacing the 2016 version. source
- The guideline contains 18 evidence-based recommendations plus 5 good practice statements. source
- It emphasises combining agents with different mechanisms and limiting the duration of systemic antibiotic use. source
Update of the EuroGuiDerm evidence-based guideline for the treatment of acne - Short version
EuroGuiDerm (European Dermatology Forum / European Academy of Dermatology and Venereology) · 2026 · Update 2025 (short version published 2026)
A targeted update of the European acne treatment guideline, published in the Journal of the European Academy of Dermatology and Venereology. It revisits selected questions on choosing between isotretinoin and systemic antibiotics, antibiotic treatment duration, hormonal therapy including spironolactone, and newer topical agents.
- Published in 2026 in the Journal of the European Academy of Dermatology and Venereology as a short version of the full EuroGuiDerm guideline. source
- It updates the 2016 European acne guideline rather than rewriting it in full, focusing on prioritised clinical questions. source
- Revised topics include benzoyl peroxide safety, choice of systemic antibiotic, treatment in pregnancy, isotretinoin dosing, and use of hormonal therapy and spironolactone. source
US vs EU key differences
- Antibiotic duration is capped more firmly in Europe: the EuroGuiDerm guideline recommends limiting systemic antibiotics for acne to three months and allows longer courses only when topicals are insufficient and neither isotretinoin nor systemic hormonal therapy is suitable, while the AAD advises the shortest effective course, generally around 3-4 months. source
- The European guideline argues for moving to isotretinoin sooner, treating it as the first-choice systemic option in many cases of severe papulopustular, moderate nodular and severe nodular/conglobate acne - deliberately going beyond the EU licence, which restricts isotretinoin to severe acne unresponsive to antibiotics. source
- EU-specific regulatory constraints shape the European text: it advises against azithromycin for acne on the basis of an EMA committee position, retaining it only as one of the very few systemic options in pregnancy, and prefers doxycycline and lymecycline over minocycline and tetracycline. source
- The AAD grades clascoterone and sarecycline only conditionally, with cost and access explicitly weighed in, while giving strong recommendations to benzoyl peroxide, topical retinoids, topical antibiotics, oral doxycycline and isotretinoin for severe or scarring disease. source
- Version currency differs by about two years: the US guideline dates to 2024, while the European guideline was updated for 2025-2026 with new voting on trifarotene, clascoterone, spironolactone and hormonal contraceptives. source
What changed recently
- EU2016 European evidence-based (S3) guideline → Update 20252026-01-01
The EuroGuiDerm update revises the 2016 European S3 acne guideline around three priority questions: when to choose isotretinoin over systemic antibiotics, how long antibiotics should run and when to use hormonal therapy or spironolactone, and how to position the newer topicals trifarotene and clascoterone. It also revises advice on benzoyl peroxide safety, choice of systemic antibiotic, treatment in pregnancy and isotretinoin dosing, leaving the rest of the 2016 text in place.
source ↗curation confidence 90% - US2016 → 2024 guideline2024-01-30
The 2024 AAD guideline replaced the 2016 version with 18 graded recommendations plus five good practice statements, adding the newer topical agent clascoterone as a conditional option and giving strong support to benzoyl peroxide, topical retinoids, topical antibiotics and oral doxycycline. It pushed multimodal combination therapy and advised against topical antibiotic monotherapy for antibiotic stewardship reasons.
source ↗curation confidence 90%
See the full update feed for changes across every system.